​Migraines . . .

​A migraine is a type of headache where the pain is severe and can last for many hours. Headaches that occur everyday are not usually migraines. Migraines can affect people of all ages, including children. Equal proportions of boys and girls suffer from migraine before puberty, but after puberty girls outnumber boys three to one. This is due to hormonal activity and the onset of menstruation (period). The first attack of a migraine usually starts before the age of 40 and the frequency and number of attacks tend to reduce, as you get older. There is a hereditary link to getting migraines.

CAUSES OF MIGRAINENo one knows the exact cause of migraine. Theories suggest that certain triggers may cause changes in blood flow to the bra in and stimulation of nerves, or that certain neurotransmitters (chemical messengers) may be released during a migraine attack. These changes may cause inflammation (swelling) in t he bra in which could lead to the pain felt The cause of migraine may be a combination of the above processes or another complex process not yet fully understood.

POSSIBLE TRIGGERS OF A MIGRAINECertain things can trigger a migraine, either as a single trigger or as several factors together.Some common triggers include:• Missed meals, or delayed meals.• Dehydration.• Lack of sleep, or too much sleep.• Head and neck pain, or a knock on the head.• In women, hormonal changes due to pregnancy or around the time of menstruation can trigger a migraine.• Stress, tension, anger, worry, depression or shock.• Over-excitement.• Flickering lights from television or computers, or bright light• Loud noises.• Strong smells.• Too much heat or cold.• Glare from the sun when outdoors or driving.• Vigorous physical activity.• Travelling for long hours.• Certain foods such as cheese, chocolate, caffeine, citrus fruits, wine or other alcohol.Triggers are not the same for everyone and may even vary for the same person at different times. Certain medicines might trigger migraines in susceptible people. Discuss this with your SelfCare Pharmacist.

SIGNS AND SYMPTOMSSome people can get a migraine every week while others may get them once or twice a year only, or very occasionally. Some people get signs that a migraine is about to come on (prodromal phase). Possible early warning symptoms include such things as raised or dulled senses, irritability, withdrawal from people, cravings for particular foods (especially sweet foods), lots of yawning, or having trouble talking. These symptoms can develop slowly over 24 hours.

MIGRAINE WITH 'AURA' A small number of people get a warning within only an hour of getting a migraine. This is known as 'aura ' and is a special type of feeling that a migraine is about to start. You may see flashing lights or zigzag lines in your vision, or even lose sight from one or both eyes. You may also get pins and needles in your hands. About 80% of people do not get an 'aura' before a migraine.

HEADACHEA migraine headache has a throbbing pain and is quite severe. The pain is usually felt on one side of the head. The headache can last anywhere from 4 hours to 3 days. Many migraine sufferers have other headache types, e.g. muscle tension headaches and 'rebound' headaches (see below), as well as migraine headache.

OTHER SYMPTOMSYou may feel sick or actually vomit (throw up). Some people may feel dizzy. Many people cannot stand bright lights, are sensitive to loud noise or any movement, and just prefer to lie down in a dark and quiet room until the symptoms pass.

SYMPTOMS IN CHILDRENYoung children who get migraines often will complain of a tummy ache (also called abdominal migraine). They may get other symptoms such as nausea and vomiting, diarrhoea (loose watery bowels), increased urination, sweating and thirst. If your child gets lots of tummy aches and you are not sure why, discuss with your doctor whether it could be due to migraines.

AFTER THE ATTACKOnce the severe headache has gone, most people get a feeling of being washed out. Or get tired achy muscles for about one to two days. Other people may actually feel happy and relaxed.

TREATMENTThere is no cure for migraine, but you can get relief by taking pain relievers such as NSAIDs (e.g. ibuprofen), paracetamol or aspirin. Sometimes a combination of these medicines, or the addition of codeine, is needed. Treatment should be started as soon as possible after the migraine attack begins. Paracetamol with metoclopramide is available from a pharmacist and this combination can help with the nausea and vomiting of migraine, as well as improve the way pain medicines work. Sometimes if you take these pain relievers too often (eg, for more than 2 days per week on a frequent and regular basis) you can get 'rebound', or medicine overuse headache. This is where you get another headache when the effect of the medicine wears off. If your migraine is severe and not helped by the pain relievers already mentioned, your doctor may prescribe other medicines such as sumatriptan, rizatriptan (in a wafer form that dissolvesin the mouth), or ergotamine. Pharmacists also can supply sumatriptan, without the need for a prescription, but only under specific circumstances of migraine symptoms, and in limited quantities. Talk to your SelfCare Pharmacist. Sumatriptan works best if taken as soon as possible after the migraine headache starts, or when other migraine symptoms begin (e.g., feeling sick, or sensitivity to light). If you get frequent migraine attacks, your doctor may put you on regular medicines to help decrease the number of attacks.​SELF CARE• Eat regular meals to keep your blood glucose at steady levels.• Drink plenty of fluids, eg water, to stop dehydration.• Mark in a diary the symptoms you experience with migraines, and the events and activities occurring as the migraine comes on, and discuss these with your doctor.• Ask your Self Care Pharmacist about the best time for you to take your migraine medicine as some need to be taken as soon as you feel an attack coming on.• Ask your Self Care Pharmacist or doctor whether you can take medicines if you are pregnant or breastfeeding.• Wear sunglasses to protect your eyes from the glare of the sun.• Relaxation exercises, meditation or yoga may help if stress and emotions trigger your migraines.• Gentle massage or hypnotherapy may also help some people.• Have regular exercise to promote wellbeing, aid relaxation and sleep, and improve the -release in the brain of chemicals that may help to protect against migraine.NZ Migraine Sufferers' Support Group has more information and advice on how to cope with migraines. Phone (09) 446 6229 or visit the migraine support website www.migraine.co.nz Mersyndol: Pharmacist Only Medicine. Ask your pharmacist if Mersyndol is right for you. Each tablet contains Paracetamol 450mg, codeine phosphate 9.75mg, and doxylamine succinate 5mg. Not for use in children under 12 years of age. May cause drowsiness. Avoid alcohol and driving. Codeine use can cause addiction. Do not use for more than three days at a time. Medicines have benefits and some may have risks. Always read the label carefully and use strictly as directed. Incorrect use could be harmful. If symptoms persist or you have side effects consult your health professional.